Organization
NORTHEASTERN PENNSYLVANIA IMAGING CENTER
Active
Organization
NORTHEASTERN PENNSYLVANIA IMAGING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIANN R. HALL MBA (PRACTICE ADMINISTRATOR)
(570) 346-6633
Entity
Organization
Contact information
Practice address
2601 STAFFORD AVE, SCRANTON, PA 18505-0305
(570) 346-6633
(570) 346-4049
Mailing address
2601 STAFFORD AVE, PO BOX 3305, SCRANTON, PA 18505-0305
(570) 346-6633
(570) 346-4049
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000072505
UNISON
PA
05
—
0011162430005
—
PA
01
—
0032528
AETNA PIN NUMBER
PA
01
—
053243
FIRST PRIORITY HEALTH
PA
01
—
1686
GEISINGER HEALTH PLAN
PA
01
—
20010377
20010377
PA
01
—
2Y6956
PHS HEALTHNET
PA
01
—
475385
HIGHMARK BLUE SHIELD
PA
01
—
999004
BLUE CROSS NE PA
PA
01
—
CB3186
RAILROAD MEDICARE
PA
Enumeration date
07/27/2006
Last updated
02/29/2012
Update your record
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